Biliary atresia (BA) is one of the most serious pediatric surgical digestive system diseases with progressive liv?er bile duct inflammation and fibrous obstruction. Currently, the etiology of BA is not clear. It may be associated with genetic predisposition, viral infections and immune injury. Now many scholars believe that it was resulted from multiple factors. Among them, the theory of immune-inflammatory is supported by most scholars. Now the mechanisms of CD38, CD138 and IgG4 in autoimmune liver disease were reported in literature. BA and other autoimmune liver diseases are similar in terms that both inflammatory and immune responses plays irreplaceable role during disease development. Therefore, this article briefly review the role of CD38, CD138 and IgG4 in the inflammation-immunity of BA.

Objective To study how to use the machine of B.BRAUN's Diapact continuous renal replacement therapy (CRRT) to achieve multiple models of plasma treatment by analyzing the characteristics of the machine.Methods Based on the machine of B.BRAUN's Diapact CRRT,assisted by extra single pump,the pipeline connection of the machine was reformed and the appropriate parameter was reset.Results After the reconstruction,the new equipment could succeed in achieving special plasma treatment such as double filtration plasmpheresis (DFPP)and plasma adsorption (PA).Conclusions The reconstructed equipment can attain special plasma treatment.Compared with plasma exchange (PE),the equipment has some characteristics such as few syndromes and without external plasma.According to its safety and stability,this new method is suitable for clinical application.

Objective In order to evaluate the quality and performance of chlorine dioxide disinfectant,it is necessary to develop a set of methods to determine the components in chlorine dioxide disinfectant.Methods Iodometry,malonic acid iodometry,improved malonic acid iodometry and five-step iodometry were employed to determine the components including ClO_2, Cl_2,ClO_2~-,and ClO_3~-in chlorine dioxide disinfectant,the advantages and disadvantages of the test methods were compared.Results Using iodometry,the liquid stabilized chlorine dioxide products activated by hydrochloric acid,the content of ClO_2 was 20.23 mg/ml that was accord with the content which was marked in the product label.Using malonic acid iodometriy,the liquid stabilized chlorine dioxide contents of ClO_2 was 19.99 mg/ml,Cl_2 was 0.35 mg/ml,in which a little chlorine was detected.Using improved malonate iodometry and five-step iodometry,the activation rates of the liquid stabilized chlorine dioxide products were 88.0% and 75.6% respectively,ClO_2 and ClO_2~-in the liquid stabilized chlorine dioxide products could be distinguished.Conclusion Active chlorine dioxide and residual ClO_2~-can be detected by using iodometriy and improved malonic acid iodometry,but iodometriy and malonic acid iodometry can not.

OBJECTIVE:To investigate the concepts and contents of the Chinese precision medicine,and to provide reference for the development of precision medicine in China.METHODS:By evidence-based evaluation method,using jingzhun yixue jingzhun yiliaoprecision medicineas keywords,all literatures were retrieved from CBM,CNKI,Wanfang,VIP,PubMed and Ovid EMBase databases up to Nov.17th,2015.The relevant information were extracted,including researchers (first author or correspondence author's unit belonged to China),domains and concepts.The concepts and contents of the Chinese precision medicine based on China's national condition were summarized and analyzed,and the difference between precision medicine and personalized medicine was compared.RESULTS:54 studies were included,the results indicated most studies (51 literatures) were published in 2015 by hospitals (28 literatures) and high schools (14 literatures);most literatures (23 literatures) presented the concept of precision medicine,followed by disease precision medicine (19 literatures) and relevant technology of precision medicine (7 literatures);a total of 39 literatures presented the specific concept of precision medicine.Besides genetic information involved in American precision medicine,the Chinese one expanded the disease diagnosis and treatment technology,as well as the application.Personalized medicine and precision medicine were in common partially,however,the latter one underlined the disease classification and diagnosis,which was more practicable.CONCLUSIONS:Chinese precision medicine involves disease diagnosis and treatment technology as well as influential factors based on genetic information,and includes disease classification and diagnosis so as to perform personalized precision intervention.The Chinese precision medicine is overall developed and focused.

Measurement of cervical lordosis is the basic method for evaluating cervical function, and important reference for determine treatment decision. However, how to choose appropriate measurement in accordance with different situation, as well as the relationship among these methods is not clear. An increasing number of studies suggested that different measurements could directly affect the judgment of cervical lordosis. Therefore, comparative study of cervical vertebrae plays an important role in clinical treatment for cervical spondylosis under different cervical curvature conditions.
Cervical Vertebrae ; anatomy & histology ; Humans ; Lordosis ; diagnosis ; pathology

Objective To assess the efficacy and safety of topiramate monotherapy in the treatment of alcohol de?pendence. Methods The Cochrane library, PunMed, EMBase, CNKI, VIP and CBM database were searched to collect the randomized contolled trials (RCTs) of topiramate monotherapy to compare with placebo or positive control drug in al?cohol dependence. Data were extracted from the included literatures after the literatures’qualities were assessed. The meta-analyses were conducted with RevMan 5.2 software. Results Thirteen trials were included. Compared with place?bo, topiramate reduced score of obsessive compulsive drinking scale(MD=-5.90,95%CI:-10.99~-0.82,P=0.02), de?creased drinks per drinking day(MD=-6.94,95%CI:-12.20~-1.68,P=0.01), and increased percentage of days absti?nent(MD=15.36,95%CI:4.15~6.56,P<0.01). The incidence of paraesthesia, taste perversion, weight loss, memory or concentration impairment, dizziness, psychomotor retardation in topiramate group was higher. But the incidence of other adverse events was similar between groups. Compared with naltrexone, topiramate significantly postponed the days to first relapse(MD=2.10,95%CI:0.23~3.97,P=0.03). The adverse events were similar between groups. Conclusions Topira?mate in treatment of alcohol dependence is effective and safety.

Objective To understand the breeding situation of Acaroid mites in indoor environments of kindergartens in Wuhu City so as to provide the evidence for its prevention and control. Methods From March to June and September to De?cember in 2014 dust samples were collected from 15 kindergartens of 3 ranks every month. Acaroid mites in the samples were isolated identified and counted. Results Totally 360 samples were selected and 169 samples 46.94% had mite infestation. Pyroglyphidae accounted for the most in the population with the breeding rate of 45.00%. Totally 18 504 mites were found and Dermatophagoides farina and Dermatophagoides pteronyssinus were the dominant species with the composition ratios of 30.21%5 590 mites and 17.83% 3 300 mites respectively. The third?ranked kindergartens were in the most serious situation con?cerning with 81.67% 98/120 of the breeding rate of Acaroid mites. The differences were statistically significant among the kin?dergartens with different ranks F=6.048 χ2=73.523 both P<0.05 . There were no significant differences about the Aca?roid mite population among different grades in kindergartens F=0.132 χ2 =2.377 both P>0.05 . Conclusion Acaroid mites in the kindergartens in Wuhu City were in serious condition and the population and species composition of Acaroid mite community is influenced by the human behavior and indoors environments.

Objective To evaluate the effect of the endotracheal tube (ETT) depth on the efficacy of bronchial blocker when used for one-lung ventilation.Methods Sixty patients of both sexes,aged 46-78 yr,weighing 48-85 kg,with body mass index＜30 kg/m2,scheduled for elective thoracotomy requiring one-lung ventilation,were divided into 2 groups (n =30 each) using a random number table:the distance between the tip of ETT and the carina was 3 cm group (group Ⅰ) and the ETT cuff was placed at 2 cm below the glottis group (group Ⅱ).The bronchial blocker was inserted under the guidance of a fiberoptic bronchoscope.The ETT depth,time to bronchial blocker position,development of bronchial blocker displacement and increase in airway peak pressure,degree of lung collapse,severity of postoperative tracheal mucous membrane injury and development of sore throat and hoarseness were recorded.Results Compared with group Ⅰ,the ETT depth was significantly shallower,the time to bronchial blocker position was shortened,postoperative tracheal mucous membrane injury was attenuated (P＜0.05 or 0.01),and no significant change was found in the incidence of bronchial blocker displacement and increase in airway peak pressure,degree of lung collapse or incidence of sore throat and hoarseness in group Ⅱ (P＞0.05).Conclusion The ETT depth the ETT cuff placed at 2 cm below the glottis can improve the efficacy of bronchial blocker when used for one-lung ventilation.

Objective To investigate the expression and significance of integrin αvβ8, p38 and extracellular signal-regulated protein kinase 1/2 (ERK1/2) proteins, which are TGF-β1 pathway related regulatory protein, in liver fibrosis of children with biliary atresia (BA). Methods Fifteen cases of BA (Kasai group) and 10 cases of congenital biliary dilatation (CBD group) were collected in Tianjin Children’s Hospital. And liver biopsy specimens were collected in Tianjin first central hospital, including 10 cases of BA children who underwent liver transplantation due to liver failure after Kasai operation (liver transplantation group). The specimens of front part of the right lobe of the liver were taken for HE and immunohistochemistry (IHC) staining. The expressions ofαvβ8, p38 and ERK1/2 in liver were observed by IHC staining in three groups of liver tissues. Results HE staining showed fibroblast hyperplasia occasionally in CBD group, portal area expansion, fibrous tissue proliferation and wide spread bridging fibrosis with few pseudo lobules in Kasai group. In transplantation group, portal area was widened, the degree of fibrosis was severe and bridging fibrosis generally formed resulted in pseudo lobules widely. Imunohistochemistry showed that the expressions of αvβ8 and ERK1/2 were weakly positive, and the expression of p38 was negative in CBD group. In Kasai group, the expressions of αvβ8, p38 and ERK1/2 proteins were all strongly positive in liver cytoplasm, biliary epithelial cells and vascular endothelial cell cytoplasm. In liver transplantation group the expressions of αvβ8, p38 and ERK1/2 proteins were all strongly positive. The semi-quantitative analysis showed that the expressions levels of αvβ8, p38 and ERK1/2 were significantly higher in Kasai and liver transplantation groups than those of CBD group (P<0.05). There were no significant differences in expression levels ofαvβ8, p38 and ERK1/2 between Kasai group and transplantation group (P>0.05). Conclusion The expressions ofαvβ8, p38 and ERK1/2 are gradually increased in liver of BA with the process of fibrosis, which indicate that they may be involved in
the process of BA liver fibrosis.

Objective To evaluate GGT in combination with B ultrasound for the diagnosis of biliary atresia (BA) infants suffering from obstructive jaundice.Methods A retrospective analysis was made on 69 sick infants including 55 BAs and 14 non-BAs as identified by intraoperative cholangiography.The preoperative laboratory GGT and ultrasound data were collected and analyzed.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy were compared.Results BA patients had significantly higher GGT than Non-BA patients (t =-4.164,P ＜ 0.05).The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of GGT ＞ 306 U/L were 69.1％,92.9％,97.4％,43.3％,73.9％,respectively.In BA group,abnormal gallbladder was significantly associated with proadening portal vein,broadening hepatic artery compared with Non-BA patients (x2 =9.995,P ＜0.05).The accuracy of abnormal gallbladder on ultrasound was 78.3％.When two method combined for the diagnosis of BA,the sensitivity,specificity,positive predictive value,negative predictive value were 92.7％,92.9％,98.1％ and 76.5％ and accuracy can reach 92.8％.Conclusions For obstructive jaundice infants with GGT ＞ 306 U/L and abdominal gallbladder ultrasound finding intraoperative cholangiography should be carried out to make definite diagnosis of BA.